AIDS-associated cancers

HIV or AIDS-associated malignancies present treatment challenges for physicians and a serious public health problem in nations with a high incidence of HIV/AIDS. Many low and middle income countries, such as in Sub-Saharan Africa, suffer disproportionally from the HIV epidemic and experience very high numbers of AIDS defining cancers.
Kaposi's sarcoma, non-Hodgkin's lymphoma (including primary central nervous system lymphoma), and cervical carcinoma are all more prevalent in individuals with HIV/AIDS. Even today they account for the majority of cancers in HIV positive persons seen at UNC and they are the leading cancers in men and women in many countries globally.

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By Channing Der

It is estimated that there are over one million people living with HIV/AIDS in the United States today, but that number is dwarfed by the over 33 million people worldwide who have the disease.

With the advent of Highly-Active Antiretroviral Therapy (HAART), HIV-infected individuals are living longer and are therefore at a higher risk for developing AIDS-related malignancies. Cancers in the context of HIV infection tend to be more aggressive and resist treatment with standard therapies.

Since 2008, UNC Lineberger, in conjunction with the UNC Center for AIDS Research, has received funding from NCI/NIH to promote basic and translational pilot research projects on HIV-associated malignancies.

Key areas for UNC include:

Collaboration in the U.S., Malawi, China and Brazil to accelerate our understanding of the basic mechanisms underlying AIDS-associated cancers and the best treatments for these malignancies.

In the U.S., UNC-Chapel Hill is a clinical site for the NCI-sponsored AIDS-associated malignancy consortium (AMC), which conducts clinical trials that enroll HIV-positive individuals with cancer.

In Malawi, nearly 50% of the population is HIV-positive and 30-40% of the HIV positive population die of Kaposi's sarcoma. Drs. Dittmer and Hoisseinipour are collaborating with several UNC-Chapel Hill investigators on cancer clinical trials in Malawi.

In China, there is a UNC Infectious Disease-initiated HIV surveillance project in Xinjiang and Guangxi Provinces which records all incidences of cancer in the HIV-positive population.

In India, Drs. Dittmer and Damania collaborate with clinicians and faculty at the TATA memorial hospital on clinical trials for lymphoma and Head and Neck cancer in persons living with HIV/AIDS.

The UNC Health Registry, a survivorship cohort of 10,000 patients, is in the process of being established and will include HIV-positive individuals with cancer.

UNC-Chapel Hill has also received a NCI supplement for Behavioral Strategies to Accrue and Retain Diverse Underserved Populations in HIV-related Malignancy Clinical Trials (Drs. Paul Godley and Dirk Dittmer are involved in this project).